A proximal hamate autograft has successfully reconstructed a proximal scaphoid non-union, achieving bone union in just 10 weeks. This innovative approach addresses complex cases where standard treatments have failed.
Proximal scaphoid fractures are notoriously difficult to heal due to compromised blood supply, often leading to non-union and osteonecrosis. This case report details a reconstruction method for severe proximal pole non-unions, including bone loss and suspected avascularity, where conventional strategies prove insufficient.
The featured technique utilizes a proximal hamate autograft as an osteochondral replacement for the damaged scaphoid pole. A key benefit highlighted is the preservation of the attached volar capitohamate ligament, potentially enhancing scapholunate stability. This local grafting option also aims to minimize donor site complications.
In a case involving a 26-year-old service member with persistent wrist pain after a scaphoid fracture, initial fixation and subsequent iliac crest bone grafting failed to achieve union. The proximal hamate autograft reconstruction resulted in union within 10 weeks, restoring near-full wrist mobility and eliminating pain.
This proximal hamate autograft technique shows promise as a viable option for select patients suffering from proximal pole scaphoid non-unions complicated by bone loss and osteonecrosis.